Substance use, including alcohol and illicit drugs, increases the risk for the acquisition and transmission of sexually transmitted infection (STI). To determine the prevalence of bloodborne STI including HIV, human T-cell lymphotrophic virus type 1, hepatitis B virus, and syphilis in residents of a detoxification and rehabilitation unit in Jamaica. The demographic characteristics and the results of laboratory investigations for STI in 301 substance abusers presenting during a 5-year period were reviewed. The laboratory results were compared with those of 131 blood donors. The substances used by participants were alcohol, cannabis, and cocaine. None of the clients was an IV drug user. Female substance abusers were at higher risk for STI. The prevalence of STI in substance abusers did not differ significantly from that in blood donors (12% versus 10%); however, the prevalence of syphilis in substance abusers was significantly higher than that in blood donors (6% versus 3%, P < 0.05). The prevalence of syphilis was dramatically increased in female substance abusers and female blood donors (30%, P < 0.001 and 13%, P < 0.05, respectively). An excess of human T-cell lymphotrophic virus type 1 was also observed in female compared with male substance abusers. Unemployment was identified also as a risk factor for sexually transmitted disease in substance abusers. The results endorsed the policy of screening detoxification clients for STI and indicate a need for gender-specific approaches to the control of substance abuse and STI in Jamaica.....read more